Biking First Aid On The Trail

The Expert: When your riding partner launches off the bike unexpectedly, it pays to know how to react--and help. That in-the-field knowledge is something that wilderness-medicine expert Judith R. Klein, M.D., BikeSkills (bikeskills.com) advisor and assistant clinical professor of medicine at San Francisco General Hospital Emergency Services, has not only taught to numerous paramedics and nurses, but also put to use during her own trail rides. While Klein's know-how--from dealing with trailside seizures due to head trauma to creating a makeshift wheelchair out of a bike--exceeds what most of us will ever comfortably put to use, she does have advice that anyone can follow when it comes to handling one of the most-common mountain-bike injuries: a broken clavicle. Read on for your first-aid brush-up.

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HIT THE "PAUSE" BUTTON Your buddy just pitched over the bar or smashed his shoulder into a tree. What's your first move? Stop. "Take a deep breath," says Klein, "and get to the injured person safely." The last thing you want to do is create another victim or make the situation worse. Then, after you're sure your buddy is breathing and not bleeding--but before you move him--ask questions: Are you okay? Do you remember your name? Do you know where you are? If he can't answer clearly, he might have a head injury. Do not move him. Instead, make him comfortable, and go get help.

CHECK FOR LUMPS Even if your friend doesn't seem dazed, or if he isn't experiencing neck pain, feel his neck to see if anything is out of place, Klein explains. "If you touch or push there and it hurts, don't move him," says Klein. "Instead, go for help." But if his neck feels fine, ask where it does hurt.

PIN IT UP Your pal is complaining about shoulder pain, so you run your fingers along his clavicle and see him wince as your fingers touch a lump in the middle of his collarbone. Bingo: It's broken. Have him hold his arm against his torso wherever it's comfortable (with the elbow bent at about 90 degrees), then immobilize the arm by pulling the bottom of his jersey up and over his forearm and elbow; use safety pins to hold it in place. Then tie arm warmers or a jacket around his body to hold his upper arm against his torso, and start walking.

WATCH FOR TROUBLE If your friend looks pale or says he feels woozy, make him lie down, elevate his feet and keep him warm (to ward off shock). "People can pass out from the pain," says Klein. "You can sometimes see it coming." Wait until he's feeling well enough to walk, then slowly help him up.

PREP FOR SUCCESS "For everyday rides, I carry Band-Aids, ibuprofen, duct tape, Benadryl [for bee stings and allergic reactions] and safety pins," says Klein. "That's a basic kit--I've actually doled these things out on rides." Any more than that is overkill--unless you're going on a multiday ride.